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Published Online: 18 September 2009

Socioeconomic Differences in Preferences and Willingness-to-Pay for Insulin Delivery Systems in Type 1 and Type 2 Diabetes

Publication: Diabetes Technology & Therapeutics
Volume 11, Issue Number 9


Background: An evaluation of patients' preferences is necessary to understand the demand for different insulin delivery systems. The aim of this study was to investigate the association between socioeconomic status (SES) and patients' preferences and willingness to pay (WTP) for various attributes of insulin administration for diabetes management.
Methods: We conducted a discrete choice experiment (DCE) to determine patients` preferences and their WTP for hypothetical insulin treatments. Both self-reported annual household income and education completed were used to explore differences in treatment preferences and WTP for different attributes of treatment across different levels of SES.
Results: The DCE questionnaire was successfully completed by 274 patients. Overall, glucose control was the most valued attribute by all socioeconomic groups, while route of insulin delivery was not as important. Patients with higher incomes were willing to pay significantly more for better glucose control and to avoid adverse events compared to lower income groups. In addition, they were willing to pay more for an oral short-acting insulin ($Can 71.65 [95% confidence interval, $40.68, $102.62]) compared to the low income group ($Can 9.85 [95% confidence interval, 14.86, 34.56; P < 0.01]). Conversely, there were no differences in preferences when the sample was stratified by level of education.
Conclusions: This study revealed that preferences and WTP for insulin therapy are influenced by income but not by level of education. Specifically, the higher the income, the greater desire for an oral insulin delivery system, whereas an inhaled route becomes less important for patients.

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Published In

cover image Diabetes Technology & Therapeutics
Diabetes Technology & Therapeutics
Volume 11Issue Number 9September 2009
Pages: 567 - 573
PubMed: 19764835


Published online: 18 September 2009
Published in print: September 2009


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Camila Guimarães
University of São Paulo, São Paulo, Brazil.
University of British Columbia, Vancouver, British Columbia, Canada.
Carlo A. Marra
University of British Columbia, Vancouver, British Columbia, Canada.
Lindsey Colley
University of British Columbia, Vancouver, British Columbia, Canada.
Sabrina Gill
University of British Columbia, Vancouver, British Columbia, Canada.
Scot Simpson
University of Alberta, Edmonton, Alberta, Canada.
Graydon Meneilly
University of British Columbia, Vancouver, British Columbia, Canada.
Regina H.C. Queiroz
University of São Paulo, São Paulo, Brazil.
Larry D. Lynd
University of British Columbia, Vancouver, British Columbia, Canada.


Address correspondence to:
Larry Lynd, B.S.P., Ph.D.
Faculty of Pharmaceutical Sciences
University of British Columbia
2146 East Mall
Vancouver, BC, V6T 1Z3,
E-mail: [email protected]

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